Prevalence, Types, Risk Factors, and Course of Intimate Partner Violence in Appalachian Pregnant Women

Intimate partner violence (IPV) during pregnancy can lead to a myriad of poor physical and psychological outcomes for both mother and child. There is a paucity of research examining IPV risk factors for rural pregnant women and on information regarding the course of the specific types of IPV throughout pregnancy. The current project was an investigation of the prevalence of IPV and IPV risk factors for different types of IPV in an Appalachian pregnant sample that contained women from both rural and nonrural locations (Study 1), and was an examination of the occurrence of any IPV and the different types of IPV throughout the course of pregnancy (Study 2). Study 1 included 1,063 pregnant women participating in the Tennessee Intervention for Pregnant Smokers (TIPS) research project. IPV prevalence rates during pregnancy, measured using a modified HITS IPV screen, were approximately 26% for psychological violence, 2% for physical violence, and 1% for sexual violence. Chi-squared analysis indicated that rural pregnant women were not significantly more likely to experience any of the types of IPV compared to nonrural pregnant women. Additionally, logistic regression analysis supported previous literature findings that pregnant women who are unmarried, younger, have an unplanned pregnancy, have high levels of stress, and have low levels of social support are at a greater risk of experiencing any type of IPV during pregnancy compared to pregnant women not possessing those risk factors. However, rural status was not a significant predictor or modifier of IPV. Study 2 participants included a subsample of 337 pregnant women who indicated they had experienced IPV at any time during the course of their pregnancy. Generalized estimating equation logistic models indicated that women who experienced IPV at some point during pregnancy were more likely to experience IPV during the third trimester. Both studies support the importance of screening for specific types of IPV throughout pregnancy. Information obtained from the current research is valuable to health care providers because it is important they are aware of IPV risk factors and that different types of IPV, especially psychological IPV, can occur at any time during pregnancy

Identifying Intimate Partner Violence during Pregnancy in Prenatal Care Settings

More than 324,000 women each year are estimated as having experienced intimate partner violence (IPV) during pregnancy. Correctly identifying women experiencing all forms and severity of IPV is necessary to inform the implementation of interventions to prevent and treat IPV. This can optimally be accomplished with data from accurate screening instruments. The United States Preventative Services Task force has recently recommended that all women who are pregnant should be screened for IPV over the course of their pregnancy and postnatal visits. Currently, clinical practice and research are hindered by the lack of validated IPV screening measurements for a pregnant population. The current review examined accuracy measures of empirically tested IPV screening measures, and evaluated them for use in prenatal health care settings. Based on the information collected and presented, recommendations regarding which screens are, and are not, appropriate to use in prenatal care settings to identify IPV were presented. Further rigorous studies are needed to identify and evaluate screening measurements and procedures to increase sensitivity and suitability for use in a variety of clinical settings for pregnant women

Depression Is More Prevalent Throughout Pregnancy and the First Six Months Postpartum in Women Low in Religious Commitment and Social Support

Abstract available through the Annals of Behavioral Medicine

Marital Status and Religious Commitment Predict Prenatal Tobacco, Alcohol, and Illicit Substance Use in Southern Appalachia

Abstract available through the Annals of Behavioral Medicine

Religious Commitment and Depression During Pregnancy

Abstract available through the Annals of Behavioral Medicine

Understanding family dynamics in a cross-cultural sample: a multi-national study

The Family Systems Circumplex Model posits that balanced levels of cohesion and adaptability are associated with positive familial outcomes, whereas extremely high or low levels of these factors are associated with deleterious outcomes. Despite the popularity and utility of this model in Western cultures, there is a dearth of empirical data supporting its use in more culturally diverse contexts. The current, preregistered study assessed the Family Circumplex Model, cultural factors, and emerging adult outcomes across seven countries (i.e., China, Iran, Nigeria, Switzerland, Turkey, the United Kingdom, and the United States). Participants were N = 3,593 emerging adults, mostly self-identifying as women (71.3%). Collaborators were participants in Psi Chi’s Network for International Collaborative Exchange (NICE) and administered measures related to family dynamics and cultural orientation to participants in a random order. Results indicated that the Family Circumplex Model did not fit cross-culturally. As such, a new model was adapted, the Expanded Circumplex Model, which demonstrated invariance across samples and between women and men. The Expanded Circumplex Model retained 6 constructs with differences regarding the separation of disengagement into 2 variables and the combining of adaptive flexibility and cohesion. The current study suggests that the cultural context in which family dynamics occur should be taken into consideration when conceptualizing family dynamics theory and measurement. Future work should seek to replicate and further apply the Expanded Circumplex Model to familial outcomes

Prevalence, Types, Risk Factors, and Course of Intimate Partner Violence in Appalachian Pregnant Women

Intimate partner violence (IPV) during pregnancy can lead to myriad poor physical and psychological outcomes for both mother and child. There is a paucity of research examining IPV risk factors for rural pregnant women and the course of specific types of IPV throughout pregnancy. The current project investigated the prevalence of IPV and the risk factors for different types of IPV in an Appalachian sample that contained pregnant women from rural and non-rural locations (Study 1). Additionally, for women reporting IPV, the different types of IPV were examined throughout the course of their pregnancies (Study 2). Study 1 included 1063 pregnant womenparticipating in the Tennessee Intervention for Pregnant Smokers (TIPS) program. IPV prevalence was measured using a modified Hurt Insult Threaten Scream (HITS) screen administered at entry into prenatal care, and rural status was defined using Rural Urban Commuting Area Codes based on the participants’ ZIP codes. Self-report prevalence rates during pregnancy were 26% for psychological, 2% for physical, and 1% for sexual IPV. With the exception of one woman, all women that reported physical or sexual violence also reported experiencing psychological violence occurring at the same time (3.5%). Chi-squared analyses indicated that rural pregnant women were not significantly more likely to experience any of the types of IPV compared to non-rural pregnant women.Furthermore, logistic regression analysis supported previous literature findings that pregnant women who are younger, have an unplanned pregnancy, have high levels of stress, and have low levels of social support, are at a greater risk of experiencing anytype of IPV during pregnancy compared to those without these risk factors. To investigate IPV over the course of pregnancy, Study 2 participants included a TIPS participant subsample of 337 pregnant women who indicated they had experienced IPV at any timeduring their current pregnancy. The modified HITS screen was administered up to four times throughout the course of pregnancy, with responses coded based on gestational age at the time of assessment (first trimester, first half of second trimester, secondhalf of second trimester, and third trimester). Generalized estimating equation logistic models indicated that women who experienced IPV at some point during pregnancy were most likely to experience IPV during the third trimester. These results speak to the importance of screening for all types of IPV multiple times throughout the course of pregnancy. If multiple screens do not occur as the pregnancy progresses, some women may not be identified as having experienced IPV, and therefore miss opportunities toassuage the possible negative health outcomes due to IPV. Information obtained from the current research is valuable to prenatal health care providers who need to be aware of IPV risk factors, and that different types of IPV, especially psychological IPV,can occur at any time during pregnancy

Salivary Cortisol Levels of Working Therapy Dogs

Research documenting the level of work-related stress among therapy dogs is limited. This research was designed to measure salivary cortisol in working therapy dogs. Certified handler/dog (Canis lupus familiaris) teams were recruited to participate from teams currently volunteering in the Tri-Cities, Tennessee area. Male and female dogs of various sizes and breeds were recruited. Ten dogs contributed fivesaliva samples. Dogs were fasted for one hour prior to procedure. Samples were collected over a continuum of events, for comparison of salivary cortisol levels in multiple environments. Samples were collected as follows: (1) sample in the dogs’ homes, (1)sample upon arrival at the “work” place, (1) sample just prior to leaving the “work” place, (1) sample just prior to being groomed and (1) sample taken at the dogs’ regular veterinarians’ offices. This design provided 1 control sample, 2 work samples, and2 samples that may be indicative of elevated stress. It was hypothesized that: 1) Salivary cortisol concentrations will be higher in samples collected during grooming and at a veterinary clinic than in samples collected at home, and 2) Salivary cortisol concentrations will be lower in samples collected during “working” conditions than in samples collected during grooming and at a veterinary clinic. Saliva was collected by placing a Salimetrics Children’s Swab (P/N 5001.06) [dimensions 8 x 125 mm] into the dog’s mouth until saturated, or less than four minutes. After examination of the descriptive statistics of (n=10) across five different environmental conditions, it was decided that one of the cases represented an outlier and was removed from data as subsequent analysis revealed a cortisol level that was more than 23 standard deviations away from the mean. Three dogs had at least one sample with insufficient quantity of saliva for analysis, and were removed from the data. A one-way repeated measures ANOVA was conducted to compare salivary cortisol levels during different environmental conditions (pre-therapy, post-therapy, home, veterinary clinic, and groomer). There was not a significant main effect for condition, Wilks’ Lambda =.299, F (9, 2) =1.17, p=.51,multivariate partial eta squared = .70. The hypotheses were not supported. This research suggests that salivary cortisol of working therapy dogs is not significantly different than home, veterinary, or grooming conditions

Intimate Partner Violence Screening Tools: Are They Valid for Rural Pregnant Women?

Introduction: More than 324,000 women per year are identified as having experienced intimate partner violence (IPV) during pregnancy. Correctly identifying women experiencing all forms of IPV is necessary to inform the development and implementation of interventions to prevent and address IPV. The Abuse Assessment Screen (AAS) and Women Abuse Screening Tool (WAST) were designed to quickly identify violence against women, but clinical practice and research are hindered by the lack of validity date for these and other similar screening tools. The purpose of the current study was to compare and validate the brief AAS and WAST against the longer well-validated Revised Conflict Tactics Scale (CTS2) in a rural pregnant population. Methods: Participants in the Tennessee Intervention for Pregnant Smokers (TIPS) program (N=540) completed several questionnaires during a prenatal visit,including the AAS, WAST, and CTS2. The AAS questions: “within the last year have you been hit slapped or physically hurt by someone?” was used for physical violence comparison with the corresponding CTS2 subscale, and “within the last year has anyone forced you to have sexual activities” was used for sexual violence comparison with the corresponding CTS2 subscale. The WAST was compared to the CTS2 subscales using the two questions “has your partner ever abused you physically” and “has your partner ever abused you sexually?” In addition, a third comparison was made between the CTS2 psychological abuse subscale and the WAST question, “Has your partner ever abused you emotionally?” There are no questions on the AAS that specifically addresses psychological abuse to use for comparison to the WAST and CTS2. Results: Prevalence of any form of IPV, as indicated by answering “yes” to any of the IPV assessment questions, was 45% for the AAS, 74% for the WAST, and 80% for the CTS2. According to the CTS2 subscales, the prevalence of physical, sexual, and psychological violence within the last year was 21%, 19%, and 76% respectively. Taking the CTS2 results as standard, sensitivity on the AAS for physical violence was 35%, and for sexual violence was 2%. Sensitivity on the WAST for physical violence was 46%, for sexual violence was 1%, and for psychological violence was 29%. Conclusions and Implications: The WAST performed better at identifying cases of physical violence than the AAS, while the two screening tools performed similarly in identifying cases of sexual violence. However, neither IPV screen identified a large number of sexual violence victims. Because the WAST includes questions regarding psychological abuse in addition to physical and sexual abuse, the WAST captured more cases of any form of IPV compared to the AAS. These results suggest that the WAST should be used with caution as a stand-alone assessment of IPV, and that the AAS should not be used as a stand-alone assessment for physical or sexual violence in this pregnant population